Why you should care

Because there may be hope for illuminating the minds of the almost 50 million people who suffer from dementia.

By Melissa Pandika

The Daily DoseNOV 16 2016

Around the time he was diagnosed with younger-onset Alzheimer’s disease, 55-year-old Brian Leblanc spent all day “just doing nothing.” The former marketing and public relations executive dozed in his recliner, often for hours at a time. At night he felt restless. He awoke at 3:30 every morning, unable to fall back asleep. He forgot to eat and shed more than 50 pounds. One day, unable to recall whether he had eaten lunch, Leblanc made a decision. “I didn’t want to go down that hole any longer,” he says. “I decided I’m going to do something each and every day to make a difference.”

Now, Leblanc tries to stay active in the daytime, fending off drowsiness by riding his bike around Pensacola, Florida,and playing with his dog Dallas, a 10-year-old Chorkie (Yorkshire terrier/Chihuahua mix). A member of the Early-Stage Advisory Group for the Alzheimer’s Association, he gives presentations a few times a month to raise awareness of the disease and advocate on behalf of patients. In the evening, he dims the alarm clock and cable router lights in his bedroom. Now he sleeps soundly. When he awakens, his mind feels sharper, his mood brighter. Spending time in the sun makes him “come alive,” he says. “It gives me a new outlook on the day.”

Light therapy seeks, in part, to help sync sleep-wake cycles, or circadian rhythms, with a 24-hour day.

Leblanc isn’t alone in trying to manage Alzheimer’s symptoms by calibrating his exposure to light. Although research on light therapy for dementia surfaced more than a decade ago, interest has burgeoned in recent years amid a lack of safe, effective medications for insomnia, depression and other associated conditions. “There’s a lot of interest” in light therapy and other nondrug interventions like art, music and touch therapy, says Susan McCurry, vice chair of research at the University of Washington School of Nursing. Dementia already affects an estimated 46.8 million people worldwide, and experts predict that interest in its treatment will continue to grow as the number of Americans who are 65 and older roughly doubles to 98 million by 2060.

Sleep problems bedevil 25 to 50 percent of individuals with mild to moderate Alzheimer’s disease. Older adults often do not get enough light exposure and, as a result, they feel groggy during the day and alert at night. A 2013 JAMA study found that participants who suffered from short, poor-quality sleep had elevated levels of beta-amyloid, a protein linked to Alzheimer’s disease. Light therapy seeks, in part, to help sync sleep-wake cycles, or circadian rhythms, with a 24-hour day. Light boxes are already used to treat seasonal depression, so Mariana Figueiro, director of the Lighting Research Center Light and Health Program at Rensselaer Polytechnic Institute in Troy, New York, expanded the concept by testing a light table that’s essentially a 70-inch TV with bluish LED lights. After four weeks of sitting at the table throughout the day in the dining area of a long-term care facility, participants slept significantly more and showed a drop in agitation and depression. Figueiro, who envisions the light tables in homes and assisted-living facilities, is working with GE Lighting and Xtra Light on their manufacture.

Lew Lim, CEO of Vielight in Toronto, is tapping into light’s potential for regeneration and repair. Users of the company’s 810 Infrared device clip a diode to their nostril to send infrared light through the nasal cavity and into brain regions dysregulated by Alzheimer’s. Mitochondria — the powerhouses of cells, including the neurons damaged in Alzheimer’s — contain an enzyme that absorbs infrared light and converts it to chemical energy. During the last step of the process, the enzyme releases a signaling molecule that triggers the expression of cellular recovery and genetic repair. A pilot study found that after 12 weeks of using the 810 and the Neuro, a device with a headset of four diodes plus an intranasal diode, dementia patients reported fewer angry outbursts, better sleep and less wandering and anxiety. While Vielight markets the 810 ($499) and the Neuro ($1,499) as wellness products, it can’t make a medical claim for Alzheimer’s before testing the devices in clinical trials. Lim says his team is submitting a clinical trial protocol for FDA approval.

To be sure, it’s still not clear whether light therapy is an effective treatment option. A 2014 review of 11 trials concluded that there isn’t enough evidence to recommend it for dementia. That’s partly because it’s hard to disentangle illness symptoms from aging changes, says study coauthor Pamela Hawranik, an adjunct professor at the University of Manitoba’s College of Nursing. Ensuring that each study participant starts at the same baseline level of dementia and light exposure also presents a challenge.

Still, Leblanc advocates a “try anything” approach. And after experiencing a bad reaction to an Alzheimer’s medication, he strongly supports nondrug strategies. “If anything could be used to benefit people with Alzheimer’s or dementia-related illness, I’m all for it,” he says. “How light affects your overall being — it’s something that a lot of people just take for granted.” He pauses. “If you think about it, you never really see an unhappy surfer.”